Health policy for persons with disabilities in Brazil: Spatial
Distribution of Specialized Rehabilitation Centers
Abstract
Objective: To analyze the spatial patterns of distribution of
Specialized Rehabilitation Centers(CERs). Methods: An
ecological-level study design, descriptive and Bayesian spatial
regression analyses was carried out using the 438 Brazilian Health
Regions. Main outcome is the “presence or absence of CER” and as
covariates the rate of PWD, health funding and socioeconomic indicators.
Modeling considered a binomial probability distribution and spatial
randomness in the Besag-York-Mollié model. Neighborhood relationships
between Health Regions were constructed using Queen-type contiguity
matrix. Results:Considering four types of disability(hearing,
intellectual, physical and visual) alone, the rate of PWD and transfers
of financial resources increase the chances of implementing an CER. In
joint analysis of disabilities, implementation of CERs doesn’t
correspond to regions with higher rates of PWD.
Conclusions:Prioritize the CER implementation according to
territorial distribution of needs is essential to improve equitable
access. Use of qualified data to identify PWD is essential for the
creation of public policies.